Medicine & Doubt

The difficulty with Bipolar Disorder and many other mental illnesses is that their symptoms aren’t always present, and the better your medication works, the less you think you need it. There are times when you feel so ‘normal’ that you begin to doubt whether there was anything wrong in the first place, and question if, just maybe, you made it all up. This is the greatest form of denial and the most dangerous source of shame. When you start believing that what you’ve experienced must be something you’ve fabricated, you also begin to believe the surface level voices of your consciousness telling you that you’re only doing this for attention, and that the drugs you are taking and the help you are seeking are a waste of precious resources and your own time. This is the difficulty with diseases that you can’t see.

You might even ask: “Is mental illness even real or is life just harder for some of us?” As a person who has taken this narrative right up to the point of taking herself off of medication because she “doesn’t actually need this” countless times, just to find herself right back where she started, hear me. This is not your fault. You did not ask for it. But if you’ve been diagnosed, it is very real.  You are wonderful and deserving of the most whole and abundant life possible, and you will not win an award for making this any harder for yourself. Take your meds.

While it is very possible that your provider has not yet nailed your diagnosis and proper treatment yet, it isn’t doing them any favors to mess with your brain’s chemistry while they work on getting it right. It took a full year of testing different combinations and dosages to nail down a regimen that would work best for me, and it likely would have taken half of that time if I had trusted my alchemist that he was using his training to the best of his ability to prescribe in my best interest.

As soon as I was allowed to take a week off of therapy, my three friends  and I took off to Hawaii to celebrate my best friend Taylah’s graduation. My mom agreed to let me go because I had shown so much progress at the outpatient wellness center, and I had convinced her that a bit of normalcy and time with my friends would be good for me. This was soon after my psychiatrist had locked in a formula he was sure would benefit me by preventing hypomanic and depressive swings, if I gave my body and mind enough time to adjust to it. Silly me, however, thought that spending a week in paradise would be the perfect replacement for said medication. I was still absolutely hooked on the idea that medication was for lunatics, and that it would completely change who I was, and that I didn’t need it. This would be my final test: if I still felt depressed and/or hypomanic in one of the most beautiful places on Earth without pills, I would finally accept my diagnosis and start taking them again, and I would do so consistently. I would give up the fight against them once and for all. 

What followed was a week of turmoil against a Hawaiian backdrop. As my providers would have predicted, not even the most jaw-dropping sunsets, nor the feeling of the soft Maui sand between my toes, nor submerging myself in the immaculate Pacific waves was enough to combat the chemical imbalance in my brain, accompanied by a severe withdrawal effect from discontinuing medication so abruptly. I was very very sad and very very anxious all at once, despite enjoying my time with my friends immensely on the surface. It was excruciating. I had to take frequent breaks from spending time with my friends to gather myself in the bathroom, to be alone, to breathe, to try to hide them all from the fact that I was deeply struggling even in a place where we had virtually no responsibility outside of enjoying ourselves. 

This was when I knew that I, in fact, had Bipolar Disorder, and it was time to stop blaming myself for it. I couldn’t help it and it wasn’t my fault, but nothing I could do now would change that simple fact. After five days of self-experimentation and returning back home to San Diego, I gave in and decided to take my pills, finally choosing to give them the chance they deserved to make me feel better. 

After dropping off my suitcase back in my childhood bedroom, the one I was so ashamed to find myself holding residence in at age 23, I scurried to the bathroom as if taking the pills sooner would somehow make the agony disappear just as quickly. I flung open my medicine cabinet and reached for the infamous orange Rx cylinders. I read the words “antipsychotic” and “antidepressant,” and realized that these words that used to make me feel ashamed and embarrassed and cynical now actually held a new kind of lightness, a freedom even. Looking myself in the eyes through the mirror like the main character of every depression medication commercial I have ever seen, I popped the circular, mini-altoid-looking-tablets into my mouth, wondering how the hell these tiny, little blobs of bitter-tasting chemicals could possibly fix my brain as I washed them down with water. Thus began my journey to recovery.

The interim was difficult, the time between the moment I decided to consistently take my pills and when they actually started to work. There were days that getting out of bed felt like an impossible feat, and times when joining my mom on her trips to the grocery store felt like running an ultra marathon, and instances in which my parents had to literally carry me from the car into our house because I couldn’t stop crying in the passenger’s seat. I was far from functional and I felt constantly and repeatedly defeated. 

My memory lapsed often, a common side effect of hypomanic episodes, making simple tasks extremely hard to accomplish. I felt incompetent, like I had lost every last brain cell and every year I spent in school had gone completely down the drain and that I was falling farther and farther behind my peers professionally every minute. It all felt so unfair. All I could think about was how it seemed unlikely that I would never be able to stand on my own two feet again, how it seemed out of the cards that I’d ever be able to work a full time job and make enough money to support myself again, considering I couldn’t endure a full two hours without bursting into tears. My sanity and sense of self was stripped. I remember feeling like the rest of the world was moving on without me, like I was supposed to be off accomplishing great things the way recent college graduates do, but instead was spending my days reading Mary Oliver’s poetry in the bathtub, searching for a single activity that didn’t make me shake with frustration. 

My parents had to restrict me from using my laptop because if they didn’t, I would stay up all night researching and reading and ruminating on other peoples’ stories who had gone through mental health crises, diagnosing myself with a new disorder with every article or essay I read. I was overwhelming my brain with information and didn’t have the ability to parse out what applied to me and didn’t. I would google search my way through my hypomanic episode, starting with “why are we here” and diving down an endless rabbit hole of theories on the origins of existence, and ending with career suggestions for people with mental illnesses, accepting my fate as someone who would never again be able to fulfill a regular full time job. It was a dark place to be, and my parents knew that eliminating my extreme access to information would be best, if even for a little while. 

This was all before my medication started to work. Right before we finally  got it right. What ended up being the secret recipe for me was a different antipsychotic and antidepressant combination than I had started with, and when I started on it, I finally had hope again. The patience, the perseverance, and the never giving up had all paid off. Slowly, and certainly not all at once, daily tasks began to feel manageable. Intrusive thoughts flooded my mind with less and less frequency. I started remembering again. I would even wake up in the morning and look somewhat forward to what the day ahead would hold. I started to feel increasingly more comfortable occupying my own mind and body again. 

If I’m being completely honest, realizing that the medication you are taking is starting to work is confusing as hell, especially because mental health medication is advertised to kick in almost instantaneously to turn your frown upside down, and it couldn’t be less like those cheesy commercials.  

The best way I can explain my experience of witnessing medication working for myself is in terms of gravity and weight. Depression, to me, is a heaviness. It’s a deep, sinking, oftentimes crushing sensation that begins on my shoulders, sinks deep down through my chest, and seeps through the rest of my body, affecting every organ as I sink deeper and deeper into its abyss. It’s a heaviness that diet and exercise can’t shake and that you can’t “self-care” or “drink some water” your way out of.  Hypomania, on the other-hand, is a complete lack of this same emotional gravity. Nothing at all could even attempt to hold you down when you’re in a hypomanic state. When hypomanic, every one of your thoughts, feelings and behaviors are elevated, unrestrained by practicality or realism or even facts.  And although hypomania can disguise itself at first as pleasant, both depression and hypomania are equally uncomfortable; one for its unrestrained loftiness, one for it’s dull, aching, crushing weight.

“Medications, the right ones, are the gravity that holds me to life.”

What medicine does is bring me back to ground level and keeps me there, where the rest of the humans are moving and shaking and being. I know my medicine is working when I can tell that I’m really living; that the emotions I’m feeling like sadness, anger, jealousy, and joy, are in response to real stimuli, things happening around or within me that prompt emotional responses, as opposed to a chemical imbalance that makes me feel sad when there is truly not a single thing to feel sad about. Medications, the right ones, are the gravity that holds me to life.  

Learning to live in this place of stability after twenty three some years of emotional turbulence is a constant journey, and I’m learning what this means for me in new ways every day. Medication has completely changed my experience with living a life. Something I was always afraid of when it came to accepting my need for mental health drugs is that it would change my personality; that I would lose my edge or my drive or my constant need to strive and excel, something I thought was so fundamental to who I was as a person. And guess what, it did do that. It did soften my edges. And I’m so much better off for it.

Because I was so used to living in hyperdrive and attending to the millions of thoughts and ideas that would run through my head per day, and because I had always received such praise for being “the hardest worker,” and “deepest thinker” and because of all of the accolades that were a product of my poor mental health, I never wanted to lose that part of me. I somehow knew medicine would tone that down, but what I never predicted was how much better my life would be when I could live in the moment instead of exhausting myself to be a star in the next one. 

Now that my brain has slowed down, the pace of my mind and the pace at which life is unfolding before me are just about matched, allowing me to really experience each and every moment in a way I have never been able to do before. I didn’t lose my ability to feel, the way I had in high school and college when the doctors I had at the time put me on one antidepressant and called it enough. The combination of medication I am on currently (antidepressant and antipsychotic/mood stabilizer)  allows me to feel more clearly actually, and more appropriately to the stimuli causing the feeling. When someone says something funny, I hear them more clearly and am listening more deeply because I don’t have all the background noise, and I therefore laugh harder and remember every word they said– it actually lands. When someone says something that upsets me, my mind allows me the moment to pause and check in with myself before responding or launching into a mental spiral of self-destructive thoughts. This is living a healthy emotional life. This is a way of experiencing the world that I am still getting used to, and I’m absolutely loving it. 

Recently, on Father’s Day, my Grandma (my hero, my twin in a past-life, my family’s absolute rock) came pitter-pattering into her living room where I was sitting on the couch, and she was so visibly thrilled to show me the photo album she was carrying. It was our family photo album from the days we would take a camping and boating trip every 4th of July. She knew I loved what I would refer to as “vintage” photos and that those days at the lake meant so much to me, so it’s no wonder she sat down right next to me and flipped open the first page with anticipation for my guaranteed-to-be-tender reaction. The pictures were incredible, especially for being taken on a Fuji film disposable camera in 2008. There was blue, sparkling water against the majestic peaks of Mount Shasta, action shots of my cousins and I wakeboarding and tubing, and so many pictures of us all laughing and dancing together among the pine trees and pitched tents, s’mores and Sunny D’s in hand. What stopped me in my tracks, though, was locating myself in each picture and taking note of what I was doing in almost every one. I looked happy, kind of, but also distant. There was a dullness in my eyes, like I was half-there. 

There was one photo in particular that really captured my attention. In the photo, my cousin was sitting beside me in a folding chair looking at the camera, laughing and smiling at whoever was taking it, and I was to her left, clad in a Speedo tie dye bathing suit, looking everything like a 90’s kid who should be running free without a care in the world, but who instead was sitting there staring off into space, clearly captive of the state of her mind. At first this photo made me deeply sad. Had I been robbed of the free, careless childhood that we all have a right to? How much more did I miss than what was in the foreground of this photo? 

A few weeks later I got to be a model in a film photoshoot for my photographer friend, Michael, who wanted to get some practice and add to his photography portfolio, and in the age of Instagram, who would say no to getting professional pictures taken? I got off work early for the perfect golden hour light, took hours getting ready and watching Youtube makeup tutorials, and researched all the latest and greatest poses and angles. We had an absolute ball taking these photos, and my best friends Mak and Teya attended as my Creative Directors and Stylists, fixing my hair and setting me up for the perfect shots along the Victorian house-clad, colorful streets of San Francisco. 

When we got the photos back from development, ironically the weekend of the 4th of July, I realized that Michael had snuck in a few candid shots of me when I wasn’t looking. He caught me in my essence: laughing, dancing, conversing with my friends over god-knows-what (probably my love for Sex and the City or the dates I was going on that week). 

Michael texted me, “I can’t get over how joyful you look in these.” And he was right. I looked so joyful. Even in these candid shots in which I wasn’t looking at the camera or posing whatsoever, you could tell I was so in the present moment, and that nothing was distracting me from living it. This is the difference medicine made for me, and oh what a gift it is to discover child-like wonder as a twenty-five year old adult thanks to some mini-altoid-looking,  bitter-tasting chemicals. 

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